Combination of Negative Pressure Wound Therapy with non-Cultured Autologous Suspension of Cells, Isolated Using the ReCell for Reconstruction of an Extensive Burn Scar

Introduction: Burn scars remain a serious physical and psychological problem for the affected people. Clinical studies as well as basic scientific research have shown that Negative pressure wound therapy can significantly increase the quality of burn wounds with comparatively low risk and stress for the patient. Negative pressure wound therapy (NPWT) has been used in the treatment of acute and chronic wounds for almost 20 years and is now widely used around the world. Of all potential applications of NPWT in burn care, using NPWT as a skin graft bolster dressing has the most supportive data and the innovative epithelial cell harvesting device enables to collect and apply a cell suspension into an area of damaged skin to enhance healing and in doing so, improve the scar outcome. The goal of this study is to evaluate whether two established methods – Negative pressure wound therapy and non-cultured autologous skin cell suspension – can be successfully combined.Method: A comprehensive electronic search was done in clinical evidence databases for clinical trials, systematic reviews and health technology studies. The databases and search engines were PubMed, Scopus and sciencedirect. The search was done up to July 2018. Key references were manually searched to find relevant studies. Result: The precise 5 mechanism of action NPW Therapy facilitates improved wound healing include: fluid removal, blood flow changes, microdeformation, macrodeformation, and maintenance of wound hemostasis. There are also several secondary effects likely pathways that alter the biology of wound healing including angiogenesis, neurogenesis, granulation tissue formation, cellular proliferation, differentiation, and migration. The cell suspension contains a mixed population of basal keratinocytes, melanocytes, Langerhans cells and fibroblasts. As the cells collected are predominantly from the basal layer, they are highly proliferative and result in enhanced epithelialization. Additionally the presence of viable melanocytes results in the appropriate pigmentation of many skin types. Conclusion: The use of combining autologous non-cultured cells harvested using the ReCell device in conjunction with the NPWH dermal template appears to provide an improved alternative to the burn scar. Not only that, but the use of non-cultured cells increases the applicability of this method to clinical situations, including the treatment of acute burns, with no time lag for the culturing of cells to be applied. It also provides a method that can be readily adopted in clinical practice. Further more research is needed in this area .

Keywords:

Negative Pressure Wound Therapy , ReCell , Burn Scar